Form Center

Outreach Request Form

2. Outreach Request Form Instructions
   The St. Charles County Police Department welcomes invitations to share safety presentations and equipment/vehicle demonstrations at community events, churches, and schools. To request our attendance at your next event, please complete and submit the below form. <b>Your request is appreciated three weeks in advance.</b> <BR> <BR> If you have questions, please contact Val Joyner, public affairs officer, at 636-949-3057 or vjoyner@sccmo.org. Thank you for your invitation.

   The St. Charles County Police Department welcomes invitations to share safety presentations and equipment/vehicle demonstrations at community events, churches, and schools. To request our attendance at your next event, please complete and submit the below form. Your request is appreciated three weeks in advance.
   
   If you have questions, please contact Val Joyner, public affairs officer, at 636-949-3057 or vjoyner@sccmo.org. Thank you for your invitation.

4. Event Title

6. Event Date and Start/End Time
   Event Date and Start/End Time Start Date

   Event Date and Start/End Time Start Time

   —

   Event Date and Start/End Time End Date

   Event Date and Start/End Time End Time

8. Event Location

10. Address

12. City

13. State

14. Zip

16. Event Summary/Overview

18. Event Purpose

20. Estimated Attendance

21. Audience
    -- Select One --Pre-SchoolElementaryPre-TeenTeenAdultSenior

22. Event Open to the Public

    1. Yes
    2. No

24. Is media invited

    1. Yes
    2. No

25. Has media confirmed

    1. Yes
    2. No

26. SCCPD Requested Resources

    Examples: Community Education, K9 Bonnie, Safety Presentation, etc.

28. Organization Requesting Resources

30. Requester Name

31. Requester Email

32. Requester Phone

34. Event Day Contact Name

35. Event Day Contact Email

36. Event Day Contact Phone

38. Link to event website or social media page

39. Event Flyer

41. What other community partners are involved?

42. Additional Details

Leave This Blank:


43. 1. Receive an email copy of this form.
44. Email address

    This field is not part of the form submission.

45. Submit

* indicates a required field